Shift Technology to Develop Fraud Database for Health Insurance Counter Fraud Group

The U.K.-based organization selected the vendor based on its reputation, commitment to and focus on insurance claims fraud detection, and the company’s expertise in data management.

(Castle Combe, Wiltshire, England. Photo credit: John Menard. )

Shift Technology, a Paris-based a provider of claims fraud detection and other claims related applications, has announced that H I Counter Fraud Group (HICFG), a U.K. industry initiative to prevent and detect fraud within health care and the insurance industry, has selected Shift Technology to develop a health insurance counter fraud database.  Delivery and production use of the database are on schedule for Sept. 2018.

Jeremy Jawish, CEO, Shift Technology.

While HICFG already had a counter fraud database in place, the association’s needs had matured and continue to change, prompting the need to look at available new options and for an industry partner able to provide a modern, quality, flexible, and fully compliant database for use by the organization’s members today and for the foreseeable future, according to a statement from Shift. The organization selected the vendor based on its reputation, commitment to and focus on insurance claims fraud detection, and the company’s expertise in data management, the statement says.

“We had heard a lot of good things regarding Shift Technology’s experience in insurance fraud detection,” affirms George Paxton, steering committee member and database project leader, HICFG.  “After learning more about their capabilities and commitment to helping mitigate losses due to fraud detection, we felt they were a natural fit to assist us with our new database needs.”

Implementation of the new health insurance counter fraud database is underway and, once completed, will provide HICFG members with a structured data system which permits authorized users to log relevant and key details, update other users through an alert system, and enable users to interrogate the database with agreed upon parameters, according to Shift.

Additional key features the database will offer to HICFG members include the following, by the vendor’s description:

  • Enable members throughout the EU and globally to participate in data logging, interrogation and extraction.
  • Development, administration, and maintenance of an audit trail of all data input and searches undertaken, and made accessible to specified users with “administration” or “super-user” rights.
  • Provide the ability to readily share best practice and emerging themes.
  • Offer the capability to easily publicize counter-fraud activity within travel and healthcare.
  • Provide alerts and intelligence to the group members from 3rd parties, such as clinical regulatory bodies and others.
  • Give members the ability to alert all users of a new case.

“This is a great win for Shift and gives us a strong foothold in the UK health industry and with an industry association,” comments Jeremy Jawish, co-founder and CEO, Shift Technology. “Insurance fraud continues to pose a significant and common challenge to insurance entities, and joining forces and collaborating as an industry through relationship likes this offers all stakeholders the best path to minimizing the impact of fraud.”

Shift Technology Brings Fraud Detection Solution to U.S. Insurance Market

Anthony R. O’Donnell // Anthony O'Donnell is Executive Editor of Insurance Innovation Reporter. For over a decade he has been an observer and commentator on the use of information technology in the insurance industry, following industry trends and writing about the use of IT across all sectors of the insurance industry. He can be reached at AnthODonnell@IIReporter.com or (503) 936-2803.

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